A Case of Perforated Meckel's Diverticulum Caused by Torsion of Its Neck

Naoto Fukuda, Kenji Okubo, Kouhei Yoda, Shigeyoshi Ito, Yukihiro Ozawa, Mitsugi Sugiyama

Critical Cara and Emergency Medical Center, Yokohama City University

A case of necrotic Meckel's diverticulum due to torsion at its neck, resulting in perforative peritonitis, is reported. The patient, a 32-year-old man was admitted with the complaint of lower abdominal pain. Emergency laparotomy was performed under the diagnosis of acute peritonitis; Meckel's diverticulum, 8.5×5.0 cm in size, was found to protrude from the lateral wall of the ileum about 50 cm proximal to Bauhin's valve, and was voluvulated about 360 degrees clockwise at its neck and necrotized. Perforation, 2 mm in diameter, was present at the body of the diverticulum, causing acute pan-peritonitis. Partial resection of the ileum and peritoneal lavage were performed. Torsion is a rare complication of Meckel' s diverticulum, and we found only 9 reported cases, including ours, in Japan. Those cases were also large in size, greater than 6 cm (mean 11.5 cm) in length, and had a narrow neck of the diverticulum. It is thought that large size and a narrow neck of the diverticulum may be an anatomical factor in torsion of Meckel's diverticulum.

Key words
Meckel's diverticulum, torsion of Meckel's diverticulum, perforative peritonitis

Reprint requests
Naoto Fukuda Critical Care and Emergency Medical Center, Yokohama City University Hospital at Urafune
3-46, Urafune-cho, Minami-ku, Yokohama, 232 JAPAN

Accepted
November 9, 1994

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